Ann Clin Neurophysiol.  2021 Oct;23(2):82-91. 10.14253/acn.2021.23.2.82.

Carotid duplex ultrasound: interpretations and clinical applications

• Choi HY

• KMID: 2521885
• DOI: http://doi.org/10.14253/acn.2021.23.2.82

Abstract

Carotid duplex ultrasound is commonly used to diagnose various carotid artery diseases due to it being noninvasive and easy to perform. Carotid atherosclerosis is a major indicator for the need to perform carotid duplex ultrasound, which can determine the degree of stenosis, plaque characteristics, and intima-media thickness. It can also be used to screen and follow-up after carotid revascularization. Here we discuss the standard techniques, interpretations, and clinical indicators for carotid duplex ultrasounds.

Figure

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  Fig. 1. Examination of internal carotid artery (ICA) and external carotid artery (ECA). (A) Low-resistance waveform of the ICA. The waveform had a blunter systolic peak and greater diastolic flow for the ICA than for the ECA. (B) High-resistance waveform of the ECA. Sharp rise in flow velocity during systole, rapid decline toward baseline, and diminished diastolic flow. (C) ECA after temporal tapping. Repeated tapping of the superficial temporal artery caused waveform oscillation (small deflection) in the ECA spectrum.

• 

  Fig. 2. Examination of vertebral artery. (A) Vertebral artery visualized between shadows from cervical transverse processes. (B) Typical vertebral artery waveform had a low resistance with continuous forward flow during diastole.

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  Fig. 3. Intima-media thickness (IMT). Bidirectional arrows indicate intima (black), media (white), and IMT (outlined).

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